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How Doulas Honor the Individual Needs of the Dying and Their Loved Ones


When it comes to death and grief, everyone responds differently.
That’s the number one lesson Judy Ashley learned in the UVM End-of-Life Doula Professional Certificate Program.
End of Life Doula Coach Judy AshleyAshley, who retired in August as director of the Vermont Department of Health’s St. Albans District Office, has long been interested in death, dying, and grief. Her father died when she was nine years old, and her mom passed away in 1985. Over the years, she’s lost friends, acquaintances, and family members. Just last month, her father-in-law died from congestive heart failure.
“For me, it’s about serving others,” she says of her passion for providing end-of-life support. “What this program has given me is the perspective that everyone is different, and we need to honor and respect that.”
While a large part of Ashley’s career has focused primarily on public health, she was also a trained bereavement counselor and volunteered for hospice.  When she came across the End-of-Life Doula program, she knew it was precisely the kind of training she wanted.
“I’m a very curious person, and this was right up my alley,” says Ashley, who lives in Swanton. “I wanted a deeper understanding. I’ve supported people during the end of life, and I have been with people who have died. But this gave me a whole other level of understanding.”

Online End-of-Life Doula Program: The Power of Compassionate Care

The eight-week online program, developed by the UVM Larner College of Medicine, in partnership with Cabot Creamery Cooperative, helps caregivers meet the growing demand for end-of-life support.
“The program provided—beyond the nuts and bolts—a level of introspection,” Ashley says. “In the program, you look at the full human experience. That can be emotional because you’re looking at yourself and asking yourself what you believe about what happens at the end of life. You realize that you need to unpack your own baggage before you can help someone else unpack theirs.”
Ashley entered the program with plenty of knowledge about death and dying. Still, she realized there was so much more that she wanted to learn.
“What are the needs of people, and how do you be there for them? How do you not give your opinion, and how do you be present and hold space?” she says. “We need to have a compassionate understanding that we’re all different.”
When her father-in-law was dying in September, Ashley provided support to her husband and his family with gentle reminders and words of comfort.  One of the things she suggested to her husband was that each of his siblings spend time alone with their father. That meant not just asking his siblings if they wanted time, but proactively giving them that personal moment with their father.
“For my husband and his family, my advice ranged from the mundane to the personal. Everyone grieves differently,” she says. “That’s the one thing to keep in mind. We think we know everything and we give advice. But I have stopped giving advice. Instead, I say, ‘What do you think? How will this play out?’ Because when you’re in the heat of the moment, it’s hard to remember what to do.”
This fall, Ashley began working as an academic coach for the End-of-Life Doula program. In this role, she helps to facilitate, review, and grade participants’ work.
Individuals enrolled in the program learn how end-of-life doulas complement the care provided by family members and friends, as well as medical, palliative, and hospice professionals.
Doulas can support clients with individualized, compassionate care in several ways, including emotional, spiritual, informational, and physical support. This support helps lower stress levels, aid in comfort, and promote personalized, even positive, dying passages for clients and their loved ones.
“I think everyone should take this course. The world would be a more compassionate place if we all understood end of life,” Ashley says. “For me, this isn’t about a career, but a way of being in the world.”

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